Trouble obsessionnel compulsif

Le trouble obsessionnel compulsif (abrégé en l'acronyme TOC) est un trouble psychique caractérisé par l'apparition répétée de pensées intrusives — les obsessions — produisant de l'inconfort, de l'inquiétude, de la peur ; et/ou de comportements répétés et ritualisés — les compulsions — pouvant avoir l'effet de diminuer l'anxiété ou de soulager une tension. Les obsessions et les compulsions sont souvent associées (mais pas toujours) et sont généralement reconnues comme irrationnelles par les personnes sujettes au TOC mais sont néanmoins irrépressibles et envahissantes, diminuant le temps disponible pour d'autres activités et menant parfois jusqu'à la mise en danger. Elles ne se fondent généralement pas sur des interprétations délirantes. Les symptômes peuvent s'exprimer de façon très variable d'un patient à l'autre (incluant phobie de la saleté, lavage des mains, vérifications répétées, obsessions sexuelles). Approximativement entre un tiers et la moitié des adultes présentant un TOC

La maison du boucher. Production artisanale de viande séchée au Pays-d'Enhaut

Nicolas Marx

La belle saison se termine, les chalets d'alpage se préparent à hiberner, tandis que le maitre armailli accompagne son cheptel. Les vaches estivées ont regagné leurs étables de plaine pendant que les fromages reposent au fond des caves de l'Etivaz. Les plus vieilles partent aux Ouges, l'abattoir communal. Siclées de vache, silence. Les bêtes, qui méritent désormais à peine leur nom, repartent pour la boucherie. Au village, une odeur entre le vivant et le mort, entre l'animal et l'aliment, annonce l'arrivée des provisions pour l'hiver. Le boucher se lève de bonne heure. Les quartiers de viande l'attendent sur sa table. Il choisit les meilleurs morceaux destinés au séchage: la longe, la sous-noix et la noix. Les autres pièces viennent remplir sa boutique pour se mettre à disposition des casseroles des villageois. Les morceaux séchés requièrent plus de patience. Avant le séchage, ils sont soigneusement recouverts d'un savant dosage d'épices: sel, poivre, girofle, thym et marjolaine. Prêts pour leur maturation, le boucher les hisse comme des drapeaux qui vont contempler les montagnes du haut de leur tour. Suspendue entre le ruisseau et les épicéas, la viande prend l'air jusqu'à la fonte des neiges. Les morceaux de viande sont prêts pour être finement tranchés, tandis que les nouvelles génisses partent à la rencontre des pâturages.

2016

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

Friedhelm Christoph Hummel, Simone Rossi

A group of European experts was commissioned to establish guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) from evidence published up until March 2014, regarding pain, movement disorders, stroke, amyotrophic lateral sclerosis, multiple sclerosis, epilepsy, consciousness disorders, tinnitus, depression, anxiety disorders, obsessive-compulsive disorder, schizophrenia, craving/addiction, and conversion. Despite unavoidable inhomogeneities, there is a sufficient body of evidence to accept with level A (definite efficacy) the analgesic effect of high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the pain and the antidepressant effect of HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC). A Level B recommendation (probable efficacy) is proposed for the antidepressant effect of low-frequency (LF) rTMS of the right DLPFC, HF-rTMS of the left DLPFC for the negative symptoms of schizophrenia, and LF-rTMS of contralesional M1 in chronic motor stroke. The effects of rTMS in a number of indications reach level C (possible efficacy), including LF-rTMS of the left temporoparietal cortex in tinnitus and auditory hallucinations. It remains to determine how to optimize rTMS protocols and techniques to give them relevance in routine clinical practice. In addition, professionals carrying out rTMS protocols should undergo rigorous training to ensure the quality of the technical realization, guarantee the proper care of patients, and maximize the chances of success. Under these conditions, the therapeutic use of rTMS should be able to develop in the coming years.

2014

Modeling the neural correlates of imitation from a neuropsychological perspective

Biljana Petreska von Ritter-Zahony

Imitation is a fundamental mechanism by which humans learn and understand the actions of others. This thesis addresses the low-level neural mechanisms underlying the imitation of meaningless gestures, using tools from computational neuroscience. We investigate how the human brain perceives these gestures and translates them into appropriate motor commands. In addition, we take a relatively unexplored neuropsychological perspective, which looks at imitation following a brain lesion. The analysis of how imitation breaks down in apraxia, a complex disorder of voluntary movement, enables us to reverse engineer brain function through the identification of those building blocks that are preserved. To better understand the phenomenon of apraxia, we develop a neurocomputational model of imitation that proposes potential neuroanatomical correlates, such as the flow of information across the two brain hemispheres. The model accounts for the pattern of errors observed in apraxic patients with disconnected brain hemispheres. To validate the predictions of our model, we further analyze the experimental errors and uncover a goal-dissociation, where a goal is defined as the spatial relation between two body parts. The experimental observations suggest that the imitation deficit in apraxia arises from an incorrect coordination between the reproductions of multiple goals. A prediction of this hypothesis was validated on three apraxic patients. The collected body of kinematic and neuropsychological data allowed us to refine our neurocomputational model of imitation, and to propose a biologically plausible mathematical model for the execution stage of the imitation. The model controls movement by following nonlinear dynamics, and precisely reproduces both the spatial and temporal aspects of unconstrained and natural three-dimensional reaching movements. Importantly, the model is stable and robust against external perturbations. Overall, our computational models and neuropsychological experiments contribute to a better understanding of how the brain performs the imitation of meaningless gestures; that is, by first decomposing the gesture into imitation goals, and then reproducing these goals through the association of different sensory modalities.

EPFL2009

Modeling the neural correlates of imitation from a neuropsychological perspective

Biljana Petreska von Ritter-Zahony

EPFL2009